Between 1998 and 2000, the number of cases of infectious syphilis in England more than doubled - from 172 to 372 in men and 102 to 156 in women. Rates were highest in London and in north west England.
These increases are largely due to several localised outbreaks, and indicate that unsafe sexual behaviour continues among both the heterosexual and homosexual populations in England, say the authors.
Few general practitioners will have dealt with a case of infectious syphilis, but these outbreaks emphasise the importance of sustained multidisciplinary public health action in this area, they add.
The general public, certain groups at risk, and relevant health professionals should be aware of the risks of acquiring syphilis and the symptoms and signs of acute infection, they conclude.